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Serious adverse events requiring immediate medical attention include: Pancreatitis: Severe abdominal pain, sometimes radiating to the back, with or without vomiting Gallbladder disease: Right upper quadrant pain, nausea, vomiting Acute kidney injury: Decreased urine output, swelling, fatigue Thyroid C-cell tumors (boxed warning for tirzepatide): Neck mass, difficulty swallowing, persistent hoarseness Metabolic considerations include the risk of hypoglycemia, particularly in patients with type 2 diabetes taking other glucose-lowering medications